Return to the MED TAC home page






MED TAC interactive forms

Med Tac Interactive Forms

Employees can fill out these forms online for submission to their employers.
All information is transferred securely and confidentially:

Enrollment form

Change Request form

Flexible Spending Enrollment form

COBRA form

Authorization cards must be submitted before employees may use these forms online. Please download the appropriate authorization card below, print it out, sign it and give to your employer.

Authorization Cards for Interactive Forms

   Interactive Enrollment/Change Request Authorization Card Download
37 kb
  Interactive COBRA Authorization Card Download
51 kb
  Interactive Flexible Spending Authorization Card Download
66 kb

Our forms are saved in 
Adobe Acrobat's *.pdf format.
Download Adobe Acrobat Reader for free:
Get Acrobat Reader for Free